Healthcare Provider Details

I. General information

NPI: 1972477479
Provider Name (Legal Business Name): KEELEY DEARING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 VETERANS PKWY STE J
MURFREESBORO TN
37128-6432
US

IV. Provider business mailing address

PO BOX 360595
PITTSBURGH PA
15251-6595
US

V. Phone/Fax

Practice location:
  • Phone: 718-215-5311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89744
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: